A person's natural tendency is to perform a known task in the same manner in which he has performed the task numerous times in the past.
Similarly, when performing a particular task, a person's natural tendency is to rely on the same equipment that he has used successfully in the past.
Additionally, where standards have been established for the completion of a particular task, a person's natural tendency is to follow the accepted standards.
In the medical profession, these three tendencies are particularly pronounced. Naturally, where a person's health and life are at stake, it is entirely justified for those in the medical profession to take a conservative approach to medical treatment by relying on trusted techniques, equipment, and standards.
While conservatism fosters the perpetuation of sound and trusted medical procedures, the continued use of reliable equipment, and the practice of accepted standards, it also fosters a certain degree of stagnation. Those in the medical profession are less likely to embrace new and untested medical techniques, equipment, and standards before they have been proven to be safe and effective. In fact, those in the medical profession are likely to follow accepted medical practices, use accepted equipment, and rely on accepted standards even though technology may have advanced sufficiently to render them obsolete or, at a minimum, cast doubt on their current efficacy or applicability.
All of this means that new medical techniques, technologies, and standards, even those that may be more cost effective and beneficial than tried and tested techniques, technologies, and standards, are slow to be adopted. This slows the progress of medicine.
Presently, in order to assess the efficacy of a change in a medical technique, technology, or standard, a physician must perform the procedure, use the technology, or test the new standard with a number of patients in a number of multi-site clinical trials. Naturally, those trials must include a control group for proper assessment of the medical technique, technology, or standard.
Following clinical trials, the physician typically describes and publishes his findings in a suitable medical journal. In addition, he may present his findings to his peers at medical conferences. As can be readily understood, this process often may take a number of years. Moreover, the sheer magnitude of the undertaking often means that only the most deserving of medical techniques and technologies and the establishment of the most beneficial standards are pursued.
In addition, the enormous costs associated with studies prohibit most doctors and physicians from testing any techniques or equipment or from establishing new standards without assistance from large companies and research organizations that have sufficient financial resources to fund these activities.
For example, when performing a diagnostic evaluation that involves the use of a medical injector in combination with a scanning device (such as a CT (Computed Tomography) or MRI (Magnetic Resonance Imaging) scanner), it may be the widely accepted practice to inject contrast media into the patient at a rate of X ml per minute to assure that the diagnostic evaluation provides useable information to the physician. The standard rate of injection probably was established through the clinical trial method described above.
It may be the case, however, that the rate of injection of contrast media may not need to be as high as the rate recommended due to advances in scanning technology. For example, the sensitivity of the scanner used for a particular diagnostic may have improved (and probably has improved) since the development of the standard(s) associated with its use. Some doctors will adapt their protocols to the capabilities of the new equipment. These are often called “rapid adopters.” However, other practitioners, despite advances in technology, may continue to use the established contrast flow rate simply because the flow rate falls within the standard established for the particular diagnostic technique.
The result of applying the established standard irrespective of any advances in medical equipment has several consequences. First, if the scanner's sensitivity has increased so that the standard flow rate is no longer required, the patient receives more contrast media than is required for the medical diagnostic. Not only does this increase the cost of the procedure (because more contrast media is used than is required), it also increases the possibility that the patient may have an adverse reaction to the contrast media. In addition, and perhaps more importantly, due to its increased sensitivity, the scanner's performance may be hindered by the use of contrast media at the standard rate if it performs optimally at a lower injection rate that is not recognized by the standard.
The same reluctance may be exhibited when new equipment is brought to the medical arena. For example, if an improved scanner is offered for use, rapid adopters will purchase and use the equipment to the benefit of their patients. Other doctors or practitioners may resist purchasing and using the equipment until its safety and efficacy are proven. As a result, patients may not benefit from the advances that the equipment offers to provide a more accurate diagnosis. Because of the cost and difficulty in proving the benefits of the improvement, as mentioned above, there often is significant delay in making this improvement available to all patients.
In summary, what the prior art and current practice fails to provide is a system or methodology for the appropriately rapid adoption of step-wise, incremental advances in medicine that develop on a continuing basis, the kind of incremental changes that result from daily practice. Simply, there are few, if any, existing mechanisms by which incremental advances may be shared with other practitioners in the medical profession to more rapidly advance medical care and quality, among other things.
The divergence between the conservative approach to the advance of medicine and the need for the reevaluation of standards and the evaluation of new medical techniques and equipment has created a technology gap in modern medicine that cries out for a solution.
At the same time, technological advances relating to information communication have been exploding. Home utility meters can automatically transmit readings for billing purposes. Copiers and other equipment can call a central office when their self-test software detects a failure or imminent failure. And, for some equipment, it is possible to remotely conduct equipment diagnosis and change equipment settings or software.